1. Claire Mearing Diabetes Lead for Dietetics in Hertfordshire
Diet and Diabetes
Claire Mearing
Diabetes Lead for Dietetics in Hertfordshire

2. New QOF Changes 2013/14
The percentage of patients with diabetes on the register, who have a record of a dietary review by a suitably competent professional in the preceding 12 months.
The percentage of patients newly diagnosed with diabetes, on the register, in the preceding 1 April to 31 March who have a record of being referred to a structured education programme within 9 months after entry on to the diabetes register.
Point 1 read then – 3points threshold month timeframe
Point 2 read then – 11points threshold 40-90

3. QOF Indicator Guidance
Much of the management and monitoring of people with diabetes is undertaken by GPs and members of primary care teams. Their role includes …………………………………… For people with diabetes, an understanding of their condition……………………………….. This includes the provision of good dietary advice and nutritional information to help people manage their diabetes.
4 pages of rationale just highlighted some sections

4. QOF indicator guidance
There are 7 dietary points to communicate to people with type 2 diabetes, for example “controls the intake of foods containing saturated and trans fatty acids”
There are 18 dietary points to communicate to people with type 1 diabetes, for example “discussion about the extent and duration of the effects of consumption of different food types and the insulin preparations”
Type 2 diabetes eg individualises recommendations for Carbs and alcohol intake
Type 1 diabetes eg matching CHO to insulin / protein intake

5. Diabetes UK Nutrition and Physical Activity Level1 Diabetes Competencies
14 sections that cover nutrition
Sections 1,3 and 6
Demonstrate familiarity with the UK nutritional recommendations, clinical practice guidelines and diagnostic criteria.
Facilitate access to community resources for nutritional advice and structured education.
Recognise when there is a need to refer for more specialist nutritional advice.
Are you familiar with the current UK reccs
Do you know who to refer to and when. New Diabetes uk and BDA./DMEG draft guidelines of who to refer and when to a diabetes Specialist dietitian. 4 page document in detail

6. So whats happening nationally?
On-line training
QoF competency certification and training is about to be launched. The e-learning topic on CDEP ( is complete and will be launched nationally in October 2013. 
It will cost £25 per person for a 2 year registration for NHS staff outside Cambridgeshire.
This will allow full access to all 8 foundation diabetes topics from the TREND competencies currently hosted and those still in development (currently underway are foot disease and BG monitoring) for the period of 2 years. 
Staff that successfully complete the individual topics (pass mark 100%) will obtain a topic specific certificate valid for 2 years.     
There is also a one day training course for on QoF programme in greater detail and therefore ability to see more involved diabetes patients and there more complex nutritional needs. Cost higher.
Takes approx 2 hours to complete dependent on speed and previous knowledge

7. Workshops on dietary issues
1. What are the current Diabetes Uk dietary recommendations?
2. How much carbohydrate is there in foods?
3. So can a carb free diet be used for people with diabetes?
15 mins in each workshop